| NPI | 1588152052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC016901) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: VA 2306602655) |
| 225200000X Physical Therapy Assistant (Licence: GA A000863) | |
| 225200000X Physical Therapy Assistant (Licence: CO PTA.00014370) | |
| 101YM0800X Counselor, Mental Health (Licence: CO LPCC0022669) | |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2026-07-27 |